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The Relationship between Maternal Vitamin D Deficiency with Gestational Diabetes

Vitamin D deficiency can lead to serious health conditions in gestational diabetes patients…

Vitamin D deficiency is a common diagnosis that affects 26-98% of pregnant women. Vitamin D deficiency has been associated with type 2 diabetes, obesity and other factors of metabolic syndrome. Another condition that is associated with insulin resistance and hyperinsulinemia is pregnancy. Increased insulin resistance in pregnant women can lead to gestational diabetes. Gestational diabetes is a serious condition that can lead to other situations such as preeclampsia, macrosomia, and cesarean delivery. Previous studies have attempted to discover the association between diabetes and vitamin D deficiency in pregnancy. Currently, there isn’t a clear link between vitamin D deficiency and gestational diabetes.

The purpose of this study was to evaluate the association between maternal vitamin D deficiency, glucose intolerance, and insulin resistance in pregnant women. The study included 21 women with gestational diabetes and 43 healthy pregnant subjects (control group). The patients were diagnosed with gestational diabetes with a 50 gram oral glucose tolerance test. The control group was stratified into two groups (control group-1 and control group-2) based on the glucose tolerance test. Vitamin D deficiency is measured by 25ohDvit levels below 10ug/l. The categorical variables was analyzed using Chi-square test. The significant variables were analyzed by Mann-Whitney U test. The three groups were compared using Kruskal-Wallis test.

The results showed that the newborn length in control group-1 was superior to the other two groups (p= 0.002 and p= 0.02). There was a negative correlation between fasting blood glucose and insulin resistance with length of the newborns (r=-0.3, p=0.03 and r=-0.3, p=0.01). Gestational diabetes group had 16 patients (76%) with severe D deficiency, control group-1 had 7 patients (47%) with severe D deficiency, and control group-2 had 17 patients (61%) with severe vitamin D deficiency (p=0.2).

To conclude vitamin D deficiency, gestational diabetes, and insulin resistance are not linked together. Lower maternal vitamin D levels is linked with insulin resistance and adverse events for the newborn. One limitation of the study is the method that was utilized to diagnosis the patients with gestational diabetes. It is very controversial on which approach to select, 50 gram or 75 gram glucose solution.

Practice Pearls:

  • Maternal vitamin D deficiency is linked with detrimental effects to the infant.
  • Women with vitamin D deficiency or gestational diabetes should be examined carefully to decrease any potential adverse outcomes to the infant.
  • During pregnancy, women with vitamin D deficiency may experience insulin resistance.

Mutlu N, Esra H, Begum A, et al. Relation of maternal vitamin D status with gestational diabetes mellitus and perinatal outcome. Afr Health Sci. 2015;15(2):523-31.